共聚焦显微镜观察2型糖尿病患者角膜神经纤维变化情况  

Observation of corneal nerve fibers in patients with type 2 diabetes by confocal microscopy

作　　者：朱艳[1,2] 张金金 潘薇[1] 田建英 ZHU Yan;ZHANG Jinjin;PAN Wei;TIAN Jianying(Department of Ophthalmology,Ningxia Hui Autonomous Region People′s Hospital,Yinchuan 750002,China;Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏回族自治区人民医院眼科,宁夏银川750002 [2]宁夏医科大学,宁夏银川750004

出　　处：《宁夏医学杂志》2023年第12期1080-1083,I0001,共5页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2022AAC03207)。

摘　　要：目的使用活体共聚焦显微镜观察2型糖尿病患者角膜神经纤维变化情况。方法本研究纳入2型糖尿病患者及正常对照人群。收集纳入人群的年龄、性别、糖尿病病程等基本信息。纳入人群均进行基本眼科检查,包括散瞳下眼底检查及角膜共聚焦显微镜检查,测量并记录角膜神经纤维长度(NFL)、角膜神经纤维密度(NFD)、角膜神经纤维分支密度(NFB)以及角膜神经纤维弯曲度(NFT)。按视网膜损害程度将糖尿病患者分为有糖尿病但无糖尿病视网膜病变组(NDR),非增殖期糖尿病视网膜病变组(NPDR)和增殖期糖尿病视网膜病变组(PDR)。结果本研究共纳入30例正常人群(30只眼)和90例2型糖尿病患者(90只眼),其中NDR组30只眼,NPDR组30只眼及PDR组30眼。对比正常组,NDR组、NPDR组及PDR组的NFL、NFD、NFB均显著降低(P<0.05),而NFT显著升高(P<0.05)。多元线性回归分析结果显示,NFL与糖尿病病程呈负相关(P<0.05);NFD与年龄、糖尿病病程呈负相关(P<0.05);NFT与年龄、糖尿病病程呈正相关(P<0.05)。结论在糖尿病视网膜病变出现前,通过活体共聚焦显微镜即可发现糖尿病患者角膜出现神经纤维的损害。随着糖尿病视网膜损害的进展,角膜神经纤维损害亦显著增加。Objective To observe the changes of corneal nerve fibers in patients with type 2 diabetes by using the confocal microscopy.Methods 90 patients with type 2 diabetes and 30 normal persons were selected,the basic data(such as age,gender,and duration of diabetes)were collected.The basic ophthalmic examinations were underwent including the dilated fundus examination and corneal confocal microscopy.The corneal nerve fiber length(NFL),corneal nerve fiber density(NFD),corneal nerve fiber branch density(NFB)and corneal nerve tortuosity(NFT)were measured and recorded.Results The diabetic eyes were divided into diabetes without retinopathy(NDR,30 cases),non-proliferative diabetic retinopathy(NPDR,30 cases),and proliferative diabetic retinopathy(PDR,30 cases)according to the degree of retinal impairment.Compared with the normal group,NFL,NFD,and NFB in the NDR group,NPDR group,and PDR group were significantly reduced(P<0.05).In addition,compared with the normal group,NFT in the NDR group,NPDR group,and PDR group was significantly increased(P<0.05).The results of multiple linear regression analysis showed that NFL was significantly negatively correlated with the duration of diabetes(P<0.05).NFD was significantly negatively correlated with age and the duration of diabetes(P<0.05).NFT was significantly positively correlated with age and the duration of diabetes(P<0.05).Conclusion In vivo,confocal microscopy is capable to detect the impairments of corneal nerve fibers in diabetic patients.With the development of retinal damage in diabetes,corneal nerve fiber damage also increases significantly.

关 键 词：糖尿病 共聚焦显微镜 角膜神经纤维 

分 类 号：R587.1[医药卫生—内分泌]